Peramivir: evidence to support the use of the first approved intravenous therapy for influenza

Peramivir: A Review in Uncomplicated Influenza

Intravenous peramivir (Alpivab™; Rapivab^®; Rapiacta^®; PeramiFlu^®), the most recent globally approved inhibitor of influenza neuraminidase, is indicated for the treatment of uncomplicated influenza in adults and children from the age of 2 years. This article, written from an EU perspective, reviews the clinical use of peramivir in this indication and summarizes its pharmacological properties. In large, randomized, double-blind, multicentre trials in previously healthy adults with uncomplicated influenza, a single infusion of peramivir 600 mg significantly shortened the median time to resolution of influenza symptoms compared with placebo and was noninferior to the recommended oseltamivir regimen in terms of this primary outcome. Albeit data are limited, results from a noncomparative phase 3 trial in paediatric patients (≈ 95% of whom were aged ≥ 2 years) with acute uncomplicated influenza receiving the recommended dose of peramivir were generally consistent with those in adults. Peramivir was generally well tolerated in children and adults participating in these clinical trials, with most adverse events of mild to moderate intensity. Given its simple single-dose regimen and with intravenous administration offering a potential advantage over oral administration in individuals with nausea, vomiting or having difficulty in swallowing, peramivir provides an additional option for treating uncomplicated influenza infection in adults and children from the age of 2 years.

Versatile One-Pot Synthesis of Polysubstituted Cyclopent-2-enimines from α,β-Unsaturated Amides: Imino-Nazarov Reaction

The imino-Nazarov cyclization of the polysubstituted pentan-1,4-diene-3-imines was realized. To this aim, a one-pot procedure involving reductive alkenyliminylation of α,β-unsaturated secondary amides with potassium organotrifluoroborates, followed by acid-catalyzed imino-Nazarov cyclization of the polysubstituted pentan-1,4-diene-3-imine intermediates, was studied systematically. This mild, operationally simple, flexible, and high-yielding protocol efficiently affords polysubstituted pentan-1,4-diene-3-imines, cyclopentenimines, and α-amino cyclopentenones, which are useful scaffolds in organic synthesis. The substituent effect at the C2 position of the polysubstituted pentan-1,4-diene-3-imines was studied by means of density-functional theory calculations. Results suggested that the electron-donating group facilitates the imino-Nazarov cyclization process.